Provider Demographics
NPI:1629155213
Name:KIRSTEN SCHOENLEBER, LLC
Entity Type:Organization
Organization Name:KIRSTEN SCHOENLEBER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRSTEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHOENLEBER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:651-645-8300
Mailing Address - Street 1:821 RAYMOND AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1509
Mailing Address - Country:US
Mailing Address - Phone:651-645-8300
Mailing Address - Fax:651-645-4603
Practice Address - Street 1:821 RAYMOND AVE STE 200
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1509
Practice Address - Country:US
Practice Address - Phone:651-645-8300
Practice Address - Fax:651-645-4603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 0781103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN301K9SCOtherBCBS
MN917271013577OtherBEHAVIORAL HEALTHCARE PRO
MN102654OtherHEALTHPARTNERS
MN6139439OtherUNITED BEHAVIORAL HEALTH